1986-629 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-629
WARREN COUNTY, NEW YORK
PER ISSION is he eby granted to Allen Rozelle
OWNER of property located at 92 Main St. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to dwelling (living area)
at the above location in accordance to application together with plot plans and other information hereto filed and.
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
CD
1. OWNER'S Address is RD #2 Fuller Road
Glens Falls, New York
N
CD
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
same.
4. ARCHITECT'S Name
w-
5. ARCHITECT'S Address
cn
rt
6. TYPE of Construction—(Please indicate by X)
)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications a
12'x14' per plot plan, specifications and application submitted rt
No. and Variance No. 1147 0'
8. Proposed Use rt
a
Two-Family Dwelling (additional living area)
cD
I-'
10.00 April 1 87 fig
PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
r•
04
Dated at the Town of Queensbury this 24th Day of September 19 86
SIGNED BY 732C for the Town of Queensbury a%
Building and Zoning Inspector /
, i
TO BE COMPLETED BY BLDG. DEPT.
cam/ Application No. _
✓own Oi Queenitury Permit Issued 19 liEGElivER.�C��4l� �F ��� URY
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 Variance No. '7 5 t0 .22,1986
p Site Plan Rev'- o. AM. 1b�� L�LQ V\ .
140 / 3 4/ — L$ - f Approved by; [ 71819 o 1213141516
• �'APPLICATION FOR ft
BUILDING AND ZONING PERMIT ; .
* * * * * * * # * * * * * * * * * * # * * * * * * * * # * * * * # * * * * #:;#
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. .
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property.is: / /// j�a z7fie e cJ2
P.O. Address ? f U//e, ikci Co%i S -ilS /v r Tel. //
/
Property Location: .q2 571-- [ - 6• /� _ Tax Map No.
Street number or building lot number
Subdivision name (if applicable) .
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
,5 s ��' '
Name P.O. Address Tel. No.
Name of builder /1//e-ri 45 z..-//,__ Address Tel. . 4.- -3--S7)%. .
Name of plumber it ft Address Tel. .
Name of mason "el-le 'i.,.)-eiVe Address .j2je,e x (. -/¢ At 4.
,,42: tel. '7470,517,53.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction Of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, - -
)(Addition to a building * drawn reasonably to scale and attached hereto,
Alteration to a building . .* showing clearly and distinctly all buildings,
(no change to exterior dimensions) -* whether existing or proposed and indicate all
_Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and 'indicate
FOR'DEMOLITION PERMIT, STATE .ZE AND • whether interior or corner lot. Show location
of water supply and location and configuration .
LOCATION OF STRUCTURES�AFP ECTED
J
of septic disposal area.
,,�---• --- * COMPLETE INFORMATION REQUIRED BELOW. • '
-''--- -- * Size of property AC2 ft X / '7. ft.
' * Existing building(s) Size ,72 , ft X 7 ft.
PROPOSED BUILDING AND USE:
* Existing building(s) Use l),:-,.e Z ir'h a .
Size of new structure /t.-ft X 1 ft
*
Foundation-pier/slab4 ra partia i
full * Proposed building, distance from property line
(circle one) * Front yard . . .l, 4- ft Rear yard ft
No. of stories (habitable space)
•
Height' (grade to ridge) /2.`/1/ ft. * Side yards ft and ft
If residential, no: of families * If on corner, setback from side street _ft
No. of rooms(excluding baths) /. * • OCCUPANCY INFORMATION
No. of bedrooms / *
•
No. of bathrooms / * PRIMARY BUILDING Primary -
heatingsystem , * . . One family dwelling
y l�061 t o a�v��'h • )Two family dwelling
Type of fuel' ..f7Ls, , �v t "
No. of fireplaces to be installed / *. . Multiple dwelling / Number of units
Will a wood stove be installed? /70 * Permanent occupancy
Central Air conditioning? - 4 0 * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial •
Ranch Contemporary Log cabin * Other
•
Raised ranch Mansion Duplex If addition,s what will use be?
Split level Oid st le Bungalow * ! O
Cape Cod Cottage Other * ACCESSORY BUILDING
Colonial, Row Town House * '‘..Detached garage/one car/ 4 wo car car '
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * . Private storage building
ESTIMATED MARKET VALUE OF *. Other '
CONSTRUCTION -3 0 00 .' *$
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/8.6 and-vl
BUILDING PERMIT APPLICATION CONTINUED - '
BUILDING SPECIFICATIONS: a
Type of construction, wood frame, fire safe,etc.. Item,, Y,>c .
Will any second-hand or ungraded lumber be used? If so, for what? .A/0
Foundation wall material CVA.!'C, 1,�1.t7�p� Thickness IS
,,
Depth of foundation below grade (to bottom of footing) , 'f P .
Will there be a cellar? He or unheated? _,-Froor sq. footage .»- "" sq ft
Will there be a basemen ' Will any por nm5 used as living space? .
(If so, what porti sq.ft. - -, pe of use? --"""
Type of roof - sloped/flat she other Material.-of roof ' h tj . a. .AliA r
. Size, wood studs "X x " s.Pacing_/i "O,C, .ligth ft, f
1e '
.« r•t
A ;;(fleax i aim6) 1,"st�. floor _ "X wto. " sphca, iq �.."0:c, s a't `2- ft,
Jb tiz $eatiis f 3 ndr-z oor - .—''t' --r-' �L-q'''a g---,� "o.,e..--ap4 d, ,
Overlays(Ceiling beams) , X 6 - spacing "- o.sc span '-'2 ft.
Roof rafters "X S) " spacing IC o.c. span /� Vft'.
'mot rus e,p `at=.).--F''' z
Exterior wall finish C L p p aSeypret D Of what material? we)q 10 .
Interior wall finish $0 Yt f /,i/A.-tC,. M 1—
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
. Is. there to be an opeP'iing between garage and welling? . ' If so,di11 a Fire-rated „ '`'
door, enclosure, d self-closing deviceprovided? ,�
Will a flue-lin chimney be installed Height above d f ft.„."-
Depth
of chi e foundation below ade ft.
Y .
Depth of fi eplace hearth f . in.
,07/.'
Water su iy - Municipal or ivate well
SEPTIC YSTEM _ Distance om ANY private well ;•ncluding adjoining pr6perties ft. .
(A r parate applicati is necessary.for any epair or new installation of septic system)
Town of Queensbury AFFIDATIT STATE OF NEW PORK
County of Warren
' .I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted;. are a true and
complete statement of all proposed work to be done :on the described premises and that all
provisions •
of the B ILDING CODE, THE ZONING ORDINANCE, and all other laws
pertaining to
the proposed work . hall be complied with, whether specified or not, and that such work is .
authorized by the owner. / . . L% �./ ,� � ,,11SWORN TO BEFORE ME THIS Si nature_/ ( c. 7V3 ..
g
�r
' . • Owner, owner's agerf?,arc°h'itect,•contractor
dayo 19 '
Notary P , lic, Warren County, N.Y.
SPECIAL CONDITIONS OF THE PERMIT: '
By
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work.
•
ANSWER ALL of the following: •
1. Gross floor area Cp
2 . Type of heat Cpr5 t-A—ar
3. Is the building mechanically cooled? ��-
4 . Percentage of area of windows and doors % -
_ A.-- Over 16% Only
1. Uo lue of gross area of walls , roof/ceiling and floors
expose to ambient conditions
2 . Floor over he - ted spaces YES NO
a. Are foundat '.on walls insulated? 'Y-E"S NO
1. If YES, 'w 'at is the R val
31 Slab on grade YES Ns
a. If YES, what is t4.- R value of insulation around
perimeter of f -000r?
4. Is baseme Bated? . YES 0
a. R value of insulation
5. peof insulation .
B. Under 16% Only
1. R value of oof \a.nd loors- osed to ambient conditions
2 . R value ofexterior walls t
3. R value of glazed area k Lhehmoipan-e, Gv ,+2 elo!w
4. R value of . doors --' '
5. R value of floors over unheated spaces —, — ri
6. R insulation - u fl Lec slab-- _
7. R v a 1 u e—of•ms-1-a b�"'ih s'ii"r a f"i on - n e a a s a
8. R va ue of:hea^t�e basemen e l w�l�.s (a ao rade _,..
9. R va,lu.e_..wof h°ea'te'd`Tasement%cellar walls (below grade)
10. Type of insulation '1.
C. Controls
1. Thermostat, maximum heat setting $D •
D. Duct Systems
1. Is duct systeAL installed in an d spaces? YES
a. If YES, R installat .73h
b. R value of du in other
E. Piping Insulation •
1. Size of hot water or cooling carrying agent
2. R value of pipe. insulation
F. Service Water Heating
1. Performance efficiency �� ;_"
2. Temperature control setting maximum '- `
G. For Swimming Pool Only.
1. Maximum heating
Telephone No. (r 292-5 // r a _+i . .
(applicant ' s(' sirgnature)`
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
(TEMP.# I DATE I (�f
CITY OR
VILLAGE if TOWNSHIP ( , , COUNTY f• , . , _
j j;L-
STREET AND NO.OR
ROAD AND POLE NO. ./ '//l i r'J '."jf / (' / //7l'1. POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS .� •` _ // //, �� /�/,�///i /
PREMISES LOCATED? ' ' - a'' SECTION / `J 7 BLOCK r LOT
OCCUPANT'S / J `' (- r BUILDING
NAME / '` �/ OCCUPANCY -" f
OWNER'S NAME // `7 / : / �- - . -,
AND ADDRESS////fir ! I %�,(` T� l tr / - 7 , I_./�- %: TE # /� f //
CURRENT / /
SUPPLIED /v � ,70 •• _/ii//- J
BY v -r FROM THEIR • / OFFICE
BUILDING WORK DEFECTS
IS NEW❑ OLD,® IS NEW .0 ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures fL MOTORS HEATERS BRANCH OFFICE USE
Lamp Receptacles CIRCUITS
Loca- ONLY
tion Side Attaeh't H.P. Watts A.W.G.
Ceding Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Geuge INSPECTION
Out •
-
side
Sub-
base
Base-
ment
1st FI-
2nd Fl,
3rd Fl. ;,
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN •
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED -
ON OR AS NEAR AS
POSSIBLE NEW OLD 1-1
/,.•AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF r •
f. MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION /7 /.' i/
PRINT NAME AND ADDRESS / q
NAME OF ,l�l�C={J ���r�. „ X SIGNATURE
APPLICANT •1 9 OF APPLICANTC J
STREET ADDRESS/1+4 2 /t O.- , f'-l ll/'/ /PC✓ TELEPHONE# f 7. 1 -.co/f
CITY OR C` h) J r� !f r COD�a. /' LICENSE NO.
POST OFFICE ( f~ 7A' Jl WHEN APPLICABLE
46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
Calk4 too / f ��18�- 7: 3o A
Jouin of Queeni‘ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME All eh Ro e He.
LOCATION 5 ) :h it--,
Date /6 Jj b/ �' Permit No. G -6oR.
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
((Framing p L
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
"INSULATION:
Foundation
Loors
Walls Qfc
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
(-:44/1/6
Building Inspector
6/86 and-vl
Jown of Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME c7-0Z�
LOCATION /uA All S 1
Date q,kl/ c6 Permit No. (Y% — 62
* * * * * * * * * * * * * * * * * * * * * * *
$0/ = APPROVED - YES / NO
ootin!/Pier Forms POOOtTlair
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
LW OW,
Building Inspector
6/86 and-vl
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